Dr. Meerman is an assistant scientist at the University of New South Wales and author of “Big Fat Myths: When You Lose Weight, Where Does the Fat Go?” Professor Brown is the head of the School of Biotechnology and Biomolecular Sciences at the same university.

When you lose 1 kilogram of fat, where does fat go with weight loss?

The interesting answer to this question is that fat gets metabolized. Dr, Meerman and Prof. Brown pointed out that originally Leifson et al. answered this question who used heavy oxygen and found out that this was metabolized into heavy water.

Technically these experiments are fairly complex, but they allow the researchers to see exactly where the body incorporates these chemicals and where they end up with breakdown of fat. The BMJ paper describes that the breakdown of 1 kg of fat follows the following pattern: It breaks down into 0.84 kg of CO2 (carbon dioxide) and 0.16 kg of H2O (water). In other words, the lungs are the primary organs that get rid of fat and the kidneys excrete the water. There is a bit of extra energy in this chemical reaction as well, which dissipates through the skin and through exhaled air.

What did health professionals think where the fat would go?

The health professionals were doctors, dieticians and personal trainers. About 65% of them thought fat would evaporate into energy/heat. About 10% thought fat would end up in the feces. 5% thought fat would turn into muscle. Another 5% thought fat would turn into sweat or urine. 8% were correct that fat would become CO2 and H2O. 7% said they did not know.

The chemistry of fat deposits and metabolizing fat

The body deposited triglycerides from the liver metabolism of sugar and fatty acids into fat cells and stored them as oleate (C18H34O2), palmitate (C16H32O2), and linoleate (C18H32O2). Part of this are many chemical reactions, including a number of enzymes. These fatty acids form esters and turn into gigantic molecules with this chemical formula: C55H104O6. The BMJ paper further says that an overall chemical description of metabolized fat would look like this:

C55H104O6+78O2→55CO2+52H2O+energy. In plain English it means that 1 molecule of fat ester (from fat storage) is metabolized together with 78 molecules of oxygen. This results in 55 molecules of carbon dioxide, 52 molecules of water and energy.

Fat turns into carbon dioxide and water

Based on this chemical reaction a calculation of the breakdown of fat into carbon dioxide and water was possible. The surprising result is that 84% of fat becomes carbon dioxide and only 16% of fat becomes water. We exhale the carbon dioxide from our lungs and it is mostly the kidneys that excrete the water. People who lose weight are aware that they have to urinate more often. But they do not notice that they get rid of a lot of carbon dioxide, as this is a subtle process.

Some observations from the fasting mimicking diet

The fasting mimicking diet (FMD) was at the center of the most recent anti-aging conference in Las Vegas I attended. This was the 25th Annual World Congress on Anti-Aging Medicine in Las Vegas, Dec. 14-16, 2017. Late in December 2017 I started 5 days of FMD and have just completed my 4th round of it (FMD is done 5 days out of each month). My main interest in doing this is to prevent heart attacks and strokes and I like the idea of stimulating telomeres for anti-aging and increasing stem cell production. See more details under this link.

Personal experience of fasting mimicking diet

I keep meticulous records of my body measurements using daily body composition scales, which I record in a booklet. Between March 23, 2018 and March 28 I lost 1.5 kg from 64.8 kg to 63.3 kg. Fat composition was reduced from 14.1% to 12.2%. Visceral fat was reduced from 6% to 5%. My muscle percentage rose from 38.1% to 39.1%. The basic metabolic rate was 1471 Calories on March 23 and went down to 1449 Calories on March 28. My body mass index went from 22.0 to 21.5.

I definitely noticed the frequent urination, something I had noticed in the past in 2001 when I lost 50 pounds over 3 months. Of course it is understandable when you reduce your daily calorie intake to 600 Calories per day that you will lose this amount of weight. People have different metabolisms. It may be that you won’t lose as much as I did.

What causes mainly weight loss?

There are many people who think that extra exercise would help you lose weight. But a publication has established that only about 8% of weight loss is due to exercising. 92% of weight loss is due to dieting.

Regular exercise is important for conditioning of your lungs, heart, muscles and joints. But to keep things in balance a reasonable diet, like a Mediterranean diet, should also be part of the regimen.

Sugar overconsumption

The obesity wave in the US started to take off between 1976 and 1980. 40 years later it is still rising. It is interesting to note that both wheat flour and sugar consumption in the US were increasing parallel to the rising obesity figures. In the 70’s the old-fashioned wheat has changed into the force hybridized Clearfield wheat, which is now 100% of the commercially available wheat. Clearfield wheat contains 7-fold higher gluten amounts than the old-fashioned wheat that your grandparents consumed. Gluten stimulates your appetite, so you crave more wheat and you crave more sugar. This becomes a vicious cycle.

Excess calories are stored as fat

The liver metabolizes sugar from regular food and from processed food into triglycerides and LDL cholesterol (the bad cholesterol that plugs up arteries). As I mentioned above, the body stores any excess triglycerides as fat and deposits the excess into fatty cells. You see from this that essentially sugar and wheat end up as fat deposits. I suggest you change your food intake into eating sensible food with fewer calories. Start by eliminating most of your sugar, wheat and processed food intake. This will help you to melt fat away as I showed with an example of my 5 day FMD.

Where Does Fat Go With Weight loss?

Conclusion

I reviewed facts about the chemistry of melting fat away. The question is where does fat go with weight loss? In the process of weight loss fat breaks down into carbon dioxide and water. I also documented how you can lose fat in just 5 days (1.1 kilogram) on a 600-calorie diet and reduce the body mass index from 22.0 to 21.5.

Most people do not recognize the importance of watching their diet to achieve weight loss. 92% of weight loss occurs as a result of dieting. Wheat and sugar consumption have a direct connection to the obesity wave that started between 1976 and 1980. I have cut out all wheat, all sugar and all processed food in 2001. This allowed me to lose 50 pounds then and my body mass index today is 21.5. It can be done, even if you are 73 years old.

If you want to lose weight, have you considered eating Mediterranean with healthy fat? A lot has changed in recent years regarding recommendations for healthy food intake. In the eighties and nineties there was a recommendation for a low fat diet, which unfortunately was high in carbs and led to obesity. We learnt from this that carbohydrates break down in the gut into sugar. This converts into fatty acids, which go in storage as fat.

Studies regarding diets with unhealthy and healthy fats

Prospective study in the US

Here is a prospective study that followed 120,877 U.S. women and men over a longer time. Every 4 years there was weight gain of 1.69 lbs. for potato chips, 1.28 lbs. for potatoes, 1.00 lb. for sugar-sweetened beverages, 0.95 lb. for unprocessed red meats and 0.93 lb for processed meats. On the other hand from vegetables there was a weight loss of −0.22 lb., for whole grains −0.37 lb., for fruits −0.49 lb., for nuts −0.57 lb. and for yogurt −0.82 lb. The researchers checked cheese out and found it mostly neutral in terms of weight gain, while butter did cause weight gain.

Lancet study from Spain

In a study from Spain that was published in the Lancet in June 2016. The researchers followed 7447 asymptomatic men (aged 55–80 years) and women (aged 60–80 years) for about 5 years. They all had type 2 diabetes and three or more cardiovascular risk factors. They were randomly assigned to three Mediterranean diet types: a Mediterranean diet with olive oil, a Mediterranean diet with nuts and a control group on a low fat Mediterranean diet.

Weight loss when on Mediterranean diet

The interesting finding after 5 years was that there was weight loss around the waist in both the patients on the Mediterranean diet with nuts and with olive oil. Their weight loss was 0.95 lbs. for the olive oil group and 2.82 oz. in the Mediterranean diet group with nuts. The Mediterranean diet group with olive oil had lost 0.22 inches in the waistline, the other group on nuts lost 0.38 inches. These are hardly impressive losses! The researchers concluded that fat restriction is not necessary on the Mediterranean diet, as there was no weight gain with unrestricted healthy fats after 5 years.

Summary from a cardiologist

Dr. Dariush Mozaffarian, a cardiologist and epidemiologist of the Tufts Friedman School of Nutrition Science & Policy wrote an editorial regarding this Spanish study: ”A handful of nuts may be 160 calories, which is more calories than a can of Coke, but that doesn’t mean the can of Coke is a better choice”. He added: “Salt, sugar, starch, processed food and trans fats should be off the menu, not fat. Healthy foods are healthy foods, and bad foods are bad. It doesn’t matter, if the food is low fat or high fat. This is a separate issue.”

Mediterranean With Healthy Fat

Conclusion

When wanting to lose weight, the key is to pay attention to your carb intake. Make sure it consists of unrefined carbs. You will do this if you eat vegetables and fruit. Cut out sugar and starchy foods as much as you can. Have lean, clean meats, but avoid red meat except perhaps for every two weeks some grass fed beef. Eat fish (important for its content of omega-3 fatty acids), also enjoy yogurt, nuts, olive oil and avocados. It is an extra benefit if you add regular exercise to this as well. You will notice that you gradually shed the unnecessary pounds. This is not a program for just a month or two. To stay well, make it a new lifestyle!

Lately coconut oil has enjoyed a renaissance. A few years back it was still considered the saturated fat villain and was accused of causing heart attacks. The problem is that clinical trials could never proof that coconut oil would cause heart attacks or strokes; it actually showed the opposite: coconut oil prevented heart attacks! This is very interesting! This story is related to a powerful lobbying campaign of the soybean oil industry.

But perhaps more interesting is the fact that the medium chain fatty acids of coconut oil have a multitude of applications in the healthcare field so that your wrinkles and hair will benefit, your teeth will get less cavities and gum disease, you will have less infections, the immune system will be stronger and you will get less heart disease. But this is not all: coconut oil has been shown to specifically fight bacterial infections, viral infections, fungal infections and some parasitic infections. Anybody interested in 36 pounds of weight loss over 1 year? With coconut oil it is possible. There are definitely health benefits of coconut oil for you, hence the title of this blog.

Tropical oils are coconut oil and palm kernel oil. These are the best sources of medium and short-chain fatty acids, which are fats ideal for cooking and frying food in a pan as both oils have a high smoking point. Coconut oil contains 64% of medium chain fatty aids (MCFA) while palm kernel oil has 58% of MCFA. Coconut oil is the one dietary oil that is least vulnerable to oxidation and formation of free radicals. This is the reason why it is safest for cooking or deep-frying. It has a melting point of 76 Fahrenheit (25 degrees Celsius). That means it is a white solid fat below that temperature and is a clear liquid oil above this temperature.

Coconut oil is composed of 48% lauric acid, 18% myristic acid, 7% capric acid and 0.5% caprylic acid. The coconut oil is a triglyceride, where three fatty acids are bound to a glycerol molecule. But when it gets in contact with our skin, the skin bacteria immediacy hydrolyze it into free fatty acids and glycerol. The same breakdown is happening in our mouth and gut by our own bacteria. The free fatty acids (FFA) are what give it the beneficial clinical effects. The FFA have antibacterial effects, antiviral effects, antifungal effects and antiparasitic effects. Specifically, lauric acid and monolaurin are the most anti-bacterial compounds of coconut oil. Coconut oil and palm kernel oil are the richest source of lauric acid; they contain almost 50% of lauric acid in their fats. In comparison, butter only contains 3% lauric acid.

Infections treated with coconut oil

Bacteria

Antibiotic resistant bacterial strains have become a serious problem in the past few years. Because of this it is important to know that the fatty acids derived from coconut oil have alternative antibiotic effects. Sinus infection can be treated by consuming coconut oil.

The CDC has reported that 75% of all cases of food poisoning are due to eating ground beef. This is due to resistant E.coli strains from beef that were fed antibiotics, so they would fatten up. The excuse of the Agro industry is that the farmers have to use antibiotics as the cattle in the crowded conditions of feedlots would otherwise get diseases. In 1993 seven hundred people got sick from eating contaminated Jack-in-the-Box hamburgers and at least 4 children died. Other common food poisoning bugs are salmonella strains. In 1994 a milk truck carrying milk that was contaminated with salmonella was shipped to an ice-cream factory in Minnesota. The contaminated ice cream was shipped to stores in several states and led to food poisoning of 224,000 people, the largest food poisoning outbreak in the US history. Giardia is another parasite that is common in India. Here is a study that showed how children with diarrhea due to giardia can be managed with coconut oil.

If you add all the cases of foodborne illnesses each year there are between 6.5 million to 81 million Americans who get sick and about 9,000 die as a result. One of the reasons of death from food poisoning is kidney disease and subsequent kidney failure; another common reason is blood poisoning.

So how does coconut oil fit into foodborne infections? When you eat 1 or two tablespoons of coconut oil three times with meals, the free fatty acids of coconut oil that are released in the gut get taken up into the blood stream and circulate in the body. If the free fatty acids encounter bacteria the medium chain fatty acids infiltrate the membrane of the bacterium and cause it to rupture. The same process happens in the gut to bacteria that do not belong there. Pathological E.coli, salmonella species and other pathological bacteria get eradicated in the same way I have just described. Other bacteria against which coconut oil is effective are H. pylori (the problem bug that causes gastric ulcers), Chlamydia pneumoniae, Haemophilus influenzae, Staphylococcus aureus (rodent study), Pseudomonas aeruginosa, Neisseria (the cause of gonorrhea) and many gram-positive bacteria (Ref.1, p. 75 and 76). I am afraid that most of these claims could not be verified by a PubMed search. PubMed had a reference regarding Salmonella and Pseudomonas aeruginosa in a mouse assay and both of these bacteria did not respond to coconut oil in various concentration. However, Clostridium difficile, which is a problem bug with chronic diarrhea patients responded to coconut oil treatment.

Some women are plagued by frequent urinary infections. Coconut oil is a simple remedy that will treat these infections and when you eat coconut oil as a supplement or cook with it regularly you are having a good chance to eliminate them altogether.

When men get older they can be plagued by benign prostatic hypertrophy. This is a condition where the prostate is enlarged and squeezes the part of the urethra that travels through the prostate gland. The end result is that he has difficulties urinating. Urologists usually recommend a shaving off the prostatic tissue through a special cystoscopic procedure.

In a study on rats coconut oil was shown to decrease the prostatic weight as a result of treatment with coconut oil. In Ref.1 Dr. Fife stated that 1 to 2 tablespoons of coconut oil three times per day with meals would bring the swelling of the prostate gland down within only a few days and urination would be back to normal. However, I did a PubMed search for human data on benign prostatic hyperplasia and could not find a single literature quotation to confirm this.

Viruses

What about flu bugs? Dr. Fife cited a case of a woman who was just starting to come down with the flu (Ref.1). He recommended that she should take 2 to 3 tablespoons of coconut oil dissolved in lukewarm orange juice with every meal. On the first day her symptoms got worse as one often sees with seasonal infections. On the second day she expected to get worse again, but to her surprise the symptoms were starting to go away. By the end of the third day all of her symptoms had gone!

Other infectious agents that respond to coconut oil are: HIV, herpes-1 and 2, Cytomegalovirus, Epstein-Barr virus (the cause of mononucleosis), influenza virus (all strains), hepatitis C virus, Coxsackie B4 virus and others. A full list can be seen on p. 75 and 76 of Ref.1.

One of the chronic virus infections is hepatitis C. A person who has this condition is at a higher risk of developing liver cirrhosis and subsequently hepatocellular liver cancer. By using Coconut oil in the stage of chronic liver infections with hepatitis C virus the medium chain fatty acids do their trick of invading the outer membrane of the hepatitis C virus. The virus particles all rupture and release their genetic codes and cannot find another way of regenerating themselves. Within a few weeks and months the person can be completely hepatitis C free. Their energy comes back as the liver function returns to normal. From here the patient can rest assured that cirrhosis of the liver and liver cancer won’t develop.

Fungal infections

This is not the end of the surprising effects of coconut oil. Yeast bugs and other fungal infections respond very well to coconut oil. Candida albicans, the cause of gut infections, chronic vaginal infections and opportunistic infections in AIDS patients gets eradicated very similarly to the flu patient described above.

Athletes foot is a fungal infection between the toes that can go on for years with frequent flare ups, but it can be eliminated in just a few days by topical application of coconut oil. If you take it internally as well, it gets secreted through your sweat glands and eradicates the yeast bugs that way.

Parasites

Giardia lamblia is the cause for a common gut infection that is picked up by outdoor enthusiast, when they drink contaminated water. Cryptosporidium is another one of these parasites that won’t make cows sick, but when we consume drinking water that has not been fully sanitized, we get abdominal cramps and diarrhea. AIDS patients get seriously ill from this. Coconut oil comes to the rescue: it will do the same as with all the other bugs: destroy the envelope of the bugs with its MCFA’s, which destroys them. There is no anti-parasitic drug resistance that would develop. Several tapeworms respond very well to coconut oil treatment. However, some parasites like F. hepatica did not respond to coconut oil.

With respect to the transmission of malaria it was found that 2% Neem oil in coconut oil is an effective anti malarial mosquito repellant for 12 hours.

Dr. Fife gave an example of the building of the Panama Canal. The contractors found that the local indigenous Indians were the most reliable workers and never got sick. Yellow fever and malaria were the two diseases that plagued imported workers. According to Dr. Fife investigators found out that the local Indians consumed coconut oil regularly, which kept them slim and infection free including free of malaria and of yellow fever (Ref. 1, p. 94). I am afraid that a PubMed check for pertinent references regarding suppression of malaria and yellow fever could NOT be found.

Dental decay and coconut oil

Due to its broad-spectrum antibiotic properties coconut oil kills the germs that cause dental decay and gum disease, called periodontitis. You will keep the dentist less busy with regular coconut oil intake and save yourself a lot of dental bills.

Less heart attacks with coconut oil

There is a connection between poor dental hygiene, which leads to chronic Chlamydia pneumoniae infection and heart disease. Regular coconut oil consumption reduces heart attack rates and mortality of heart disease. Although the long-chain fatty acids of saturated fat and trans fat (hydrogenated vegetable oils) have been shown to cause hardening of the arteries (arteriosclerosis), this is NOT the case for medium-chain fatty acids from coconut oil. Research has shown that coconut oil is neutral with respect to blood cholesterol. Medium fatty acids are directly metabolized into energy by the liver, so they do not continue to circulate in the blood stream like other fats. In coconut consuming areas like Sri Lanka and Kerala, India very little heart disease was registered until the early 1980’s. Then only one of every 100,000 deaths was attributed to heart disease in Sri Lanka; and only 2.3 out of 1000 people in Kerala, India suffered from coronary artery disease in 1979. In contrast in the US about 333 out of 1000 Americans die of coronary heart disease every ear, that’s 1 in 3 people! Cardiovascular protection is further discussed here.

In this context it is interesting to read on this website that they believe coconut oil would cause heart attacks. Another study in Malaysian volunteers showed the opposite: no sign of changes in cholesterol, triglycerides or inflammatory markers. Many other studies have also shown that the medium chain fatty acids of coconut oil are neutral or beneficial in terms of cardiovascular disease.

Corn oil, safflower oil, grape seed oil, soybean oil, cottonseed oil, canola oil, peanut oil and even olive oil are increasing the risk for blood clots, which in turn is a risk for developing heart attacks and strokes. They are also omega-6 fatty acids that lead to inflammation and indirectly cause heart attacks and strokes. On the other hand, omega-3 fatty acids and the medium chain fatty acids of coconut oil reduce the risk of clot formation. This means there are only three safe oils: omega-3 fatty acids, coconut oil and olive oil when used non-heated and in combination with either omega-3 or with coconut oil. When combined with one or two of the other oils the blood clotting property of olive oil is neutralized.

Coconut oil is protecting the skin against damage, heals and gives it a healthy and youthful appearance. It has been observed in Polynesians who are exposed to a lot of sun that they are protected from sunburns by applying coconut oil, and their skin remains youthful looking into an older age without the development of precancerous or cancerous skin conditions. They are eating coconut oil and put it onto their skin as a lotion. Coconut oil helps for extremely dry skin. At the same time it prevents bacterial, viral and fungal infections.

In one study mild to moderate atopic dermatitis skin rashes improved significantly with virgin coconut oil. Many cosmetics contain coconut oil and you may wonder how safe this is. A safety study has been performed regarding coconut oil based cosmetics and you can rest assured that it was found to be very safe.

Even hair can be treated with coconut oil. Dr. Fife quotes a New York hair stylist Amanda George who said: “I massage two teaspoons of warm coconut oil into my hair before bed, then wash it out in the morning.” Her hair is luxuriant, soft and shimmering (Ref. 1, p.135).

Alzheimer’s disease

Coconut oil has an inhibitory effect in terms of the development of Alzheimer’s. It seems that the medium chain fatty acids prevent aggregation of amyloid-β peptide and thus stop the further development in the direction of Alzheimer’s; coconut oil also helps reduce elevated LDL, insulin resistance and hypertension, which are all risk factors for Alzheimer’s disease.

Detoxing with coconut oil

When you first use coconut oil it can have a strong detoxification effect (medically termed “Herxheimer reaction”). It stimulates the immune system and helps the body to get rid of any stored toxins and germs. There can be a skin rash, sinus congestion, nausea, vomiting, fatigue and diarrhea. Not everybody experiences all of these symptoms, but one or the other. This can go on for a day or two, but sometimes it may take longer like several weeks. It may feel as if you are coming down with a flu, but this is not true: you are detoxifying and you will feel more energetic when this is behind you. Coconut oil is hypoallergenic, so it is very rare to have a true allergy to coconut oil. Most people do not experience the above described detoxification reaction.

Lose weight while eating coconut oil

Medium chain fatty acids (MCFA) from coconut oil have a different metabolism than long chain fatty acids (LCFA) like soybean oil, canola oil, safflower oil and others. Studies have shown that MCFA are burnt directly by the liver and lead to a higher body temperature production, called “thermogenic effect”. Various researchers found a two to threefold higher burning of calories in MCFA compared to LCFA. Over one year this translated into a weight loss of 36 pounds, if you replaced all of the LCFA fats in your diet with MCFA fats. Here is a clarification that coconut oil has medium chain fatty acids and is metabolized differently than animal fats. The weight loss happens like a “side effect” when you switch to cooking with coconut oil and supplementing with coconut oil. Here is a weight reduction study that was done in 20 healthy, obese Malay volunteers. They were all males.

Cancer

The role of coconut oil in cancer treatment is not yet investigated. Carbohydrate restriction is one way of starving tumor cells. It is conceivable that a ketogenic diet including coconut oil may be beneficial for cancer patients, but trials to this effect have not yet been done, which means we do not have the evidence for or against it. However, here is a study that showed that breast cancer patients had much less side-effects with chemotherapy when supplemented with coconut oil.

Health Benefits Of Coconut Oil

Conclusion

Coconut oil has experienced a renaissance in the last view years. It is now available in containers of various sizes as organic virgin coconut oil. Try a small container first and see how you react. In the beginning you may detox and feel like you have the flu for a few days. But later you will have more energy and you’ll gradually notice improvements of energy, of skin and hair. Your body will notice further improvements internally as the immune system functions better and you lose a few pounds. Your heart is pumping blood easier as there is less hardening of the arteries. Cook with coconut oil, as the smoking point for coconut oil is higher than olive oil, which means you are not eating oxidized or toxic oil. Use olive oil in your salad dressings. Throw away all the other oils, such as safflower oil, canola oil, sunflower seed oil, corn oil and soybean oil or grapeseed oil. These are largely omega-6 containing oils that cause heart attacks and strokes as they get oxidized and cause inflammation in the body through the arachidonic acid system.

Remember this: cook with coconut oil and use olive oil for salad dressings.

Read labels and make sure you are not buying the cheaper hydrogenated coconut oil with free radicals in it; opt for the cold pressed, virgin coconut oil, which is more expensive, but healthy.

In reviewing Dr. Fife’s “The Coconut Oil Miracle” I found that there are many experiential stories that may ultimately be true, if confirmed by trials or studies. I have attempted to find references, but could not find them for all topics mentioned above; be cautious regarding these gaps. I recommend that you keep an open mind, but at the same time stay critical. I think the overall evidence supports that coconut oil is a valuable nutrient that has many positive effects.

Incoming search terms:

Recently an industry sponsored study was reviewed by the media with this headline: “Diet soda helps weight loss, industry-funded study finds”. Before you get too excited about this study, let me tell you that you are being deceived. Essentially the study compared 150 overweight or obese people on water and a similar group of people on diet sodas. Both groups were counselled on the benefits of exercise and a healthier diet. At the end of 12 weeks the water group that did not drink diet sodas had lost 9 pounds, while the diet soda group that continued their former habit lost 13 pounds. The question now is why this 4 pound difference? The sponsor of the study would like you to think that the soda diet drink is healthier, because it helps you to lose weight. Let me explain to you that there are a few flaws in the study as follows.

1. Most often there are confounding errors in industry-sponsored studies. Even though it looks on the surface that the two groups were comparable, researchers should have checked out various parameters like sex distribution, other underlying illnesses, mental state (depressed or not etc.), diabetes and other factors to make sure that there is no metabolic bias between the two groups from the start of the study.

2. Deception built into study: we know from other studies that on the long-term diet sodas lead to weight gain by stimulating your appetite for sweets and their subsequent consumption. Often short-term studies show the opposite effect, so it would be false to assume that long-term results would be similar. But most readers who read this quickly would be tempted to think “so it must be OK to continue to consume diet soda drinks!” Off you go to the grocery store and buy another 6 or 12 pack. That’s exactly what the industry-sponsored study set out to do. Somewhere in the back-room of a big soft drink corporation the executives discussed among themselves that their statistics were bad; the sales of diet soft drinks were down; there was too much negative press fuelled by the health food industry. They had to do something about this, so they designed a study where the good guy was the diet soft drink. If the consumer is not buying the results, at least the study helped to confuse people and whenever there is confusion, at least part of the confused population will return to their old habits. After all the study showed “ it is OK”.

Industry Sponsored Diet Soda Study Deceptive

3.Excitotoxins are not OK. Unfortunately all artificial sweeteners are toxic to your brain, they are excitotoxins. MSG is another excitotoxin. The only exception is the natural sweetener stevia, a plant product, which is OK. Splenda is an insecticide, so this is belongs to the xenoestrogens, bad for you as it acts like a foreign estrogen and has cancer-promoting qualities when exposed to it for several decades. The rest of the artificial sweeteners are excitotoxins: they burn your brain cells very slowly and can lead to dementia. Unfortunately they are addicting and your brain will make you feel good when you drink more of it. So, the real reason why the study group on diet sodas did better than the water group is because they did not have to change that habit, there was no withdrawal to deal with and they felt fine. So they could concentrate on dieting and exercising and of course you would lose 13 pounds in 12 weeks doing that. The water group on the other hand had to cope with diet soda withdrawal and on top was challenged by an exercise and weight loss program. As there was no diet restriction, they could compensate a bit for their trouble of withdrawal and eat a few muffins or some extra bread to make up for the lack of their comfort diet drink fix (the satisfaction of consuming the excitotoxin). This slick short-term study design is what should have alarmed the publisher to ask a few hard questions.

4. There needs to be an internal logic in the study: Let’s do a thought experiment where we repeat the study and start with two comparable overweight/obese groups of people and put them on no sugar and no refined carbs for 2 weeks and also on no diet sodas for the same time. After two weeks they are both accustomed to this diet and the no diet soda habit and they have probably lost the same amount of weight from the calorie restriction. Now we start the one group on diet sodas and the other group on water, but strictly controlled for a similar calorie intake in terms of other foods or drinks as much as is humanly possible. I would predict that after 12 weeks the water group will have at least lost the same weight as the diet soda group, if not more. The diet soda group likely will have had some problems with sugar craving and may have had more dietary indiscretions (sneaking in snacks and underreporting them), but this would show up as weight gain.

You may be proud of having completed this well controlled study. The trouble is that your industry sponsor that produces the diet drinks will not like this outcome and would not allow the results to be published. In fact that kind of result would be actively suppressed.

Conclusion:

The diet soda study discussed here is a lesson in biased publishing. We are constantly bombarded by an endless string of meaningless publications that are designed to make the consumer insecure, or bias us for accepting a company’s product in the hope of achieving a certain result (like high sales). Even, if this is not accomplished the company has sold enough of their product just for giving it a try. Beware of the door-to-door sales person. This figure is very much present right in this publication. In this case it is the sales pitch of the diet soda manufacturers! You are looking at a study that was designed to make you buy more of the excitotoxin (aspartame or other artificial sweeteners), which likely contributed to your extra weight or obesity in the first place. It’s up to you to shut the door on this sales pitch. Instead of a diet soda I suggest you make your own drink: squeeze half an organic lemon and top this with mineral water of your choice. Sweeten it with a tiny amount of stevia. This has no calories and does not stimulate you to eat more sugar and starchy foods; but it quenches any thirst and you even get some water-soluble vitamins in the process.

The Dietary Supplement Health And Education Act of 1994 made it easier for people to acquire supplements and vitamins from health food stores. But since then there has been a proliferation of various products that are sold as supplements and not as drugs. It may give you the impression that all supplements are harmless, but this is not so. There are some supplements like vitamin A where you need to watch that you are not inadvertently overdosing, as toxicity is a problem; calcium supplements are also potentially toxic, if overdone. And amino acid supplements (protein supplements) can lead to an overdose of brain hormones. Here is a sample of some of the supplements that I would want you to watch.

It is now known to be due to “pseudotumor cerebri”, a condition that mimics a brain tumor, but is caused by an acute overdose of vitamin A contained in liver (Ref. 1).

In the US where people eat enough meat, fish and dairy products, there is no overt vitamin A deficiency. Read this link to avoid overdosing with vitamin A in multiple supplements.

Overuse Of Supplements Can Create Health Risks

2. Vitamin C:

Vitamin C is an important antioxidant vitamin and is needed as a co-factor for many metabolic reactions. It is participating in the production of collagen and connective tissues, helps with fatty acid transport and is necessary for the synthesis of neurotransmitters in the brain (Ref.2). The lack of vitamin C is known as scurvy; symptoms include bleeding gums from fragile capillaries, delay in wound healing and impaired bone metabolism. Although in the earlier research it was hoped that vitamin C would prevent colds and cure cancer, more recent reevaluations found that it does not prevent you from getting colds, but it accelerates the recovery from colds by cutting down the recovery time by as much as 25 to 30% and it also does have some cancer protective effects (Ref.2). Higher doses seem to be more beneficial, but 1500 mg per day seems to now be the consensus of a reasonable upper dose limit per day.

What about kidney stones? Several studies in the past have warned about vitamin C being broken down in some people into calcium oxalate kidney stones. Here is a brief review of the literature with regard to kidney stone formation. A study regarding the DASH diet, which is used for people with high blood pressure, showed that the incidence of kidney stones is almost half for both men and women compared to controls on a normal North American diet.

Many inhabitants of industrialized countries including the population in the US and other countries are magnesium deficient and this can be a major factor for forming calcium oxalate stones. But it has been known for decades that those who develop kidney stones excrete more oxalates in their urine (so-called “oxalate excreters”). Here is a 1996 study that measured this in detail.

If you are taking in a lot of green smoothies from green leaf vegetables (spinach, kale, Swiss chard) that are high in water-soluble vitamins, you may not require any vitamin C supplements. In other words, think about what else you do and eat and add it up, so you do not exceed a total of 1500 mg to 2000 mg of vitamin C per day.

If you are taking in a lot of green smoothies from green leaf vegetables (spinach, kale, Swiss chard) that are high in water-soluble vitamins, you may not require any vitamin C supplements. In other words, think about what else you do and eat and add it up, so you do not exceed a total of 1500 mg of vitamin C per day.

3. Calcium supplements:

Calcium is a key mineral in the body, important not only for healthy bone structure, but also to balance the electrolytes within the blood, in the extra cellular fluid space and within our cells. If calcium is low, the brain is more prone to seizures and the heart can produce dangerously irregular heart beats. We definitely need a balance of calcium! Because calcium is so central to our wellbeing, several factors work together to keep our calcium levels stable: the kidneys, the thyroid, the parathyroid glands, the adrenal glands, the bone as a reservoir of calcium, the gastrointestinal tract for absorption and a good, balanced nutrition. The chapter on “Vitamins and Minerals” of Ref.3 points out that 4000 mg of calcium per day definitely causes toxicity (hypercalcemia and milk-alkali syndrome).

Absorption is dose dependent meaning that only 500mg of calcium carbonate is absorbed at a time. Vitamin D3 deficiency leads to reduced calcium absorption. But with high doses of vitamin D3, which is now often recommended, more calcium is absorbed, so it is important not to take too many calcium supplements. They can also interfere with iron and zinc absorption and when more than 2600 mg of calcium is taken magnesium absorption is inhibited as well. Calcium can interfere with thyroid hormone supplements (take 4 hours apart) and may reduce the effect of calcium channel blockers, drugs used for angina or high blood pressure. There is a balance between calcium stored in bone (99% of total body calcium) and the circulating portion of 1% of calcium in the blood. The parathyroid hormone and calcitonin are also involved in this balance. Hypercalcemia is the condition when calcium is too high. Common causes are the improper use of diuretics (thiazide diuretics), overuse of calcium carbonate supplementation (often for osteoporosis) and overuse of vitamin D3, which increases the absorption of calcium (Ref.3). See your family doctor for blood tests and advice what to do in your case.

4. High protein diets and protein (amino acid) supplements:

Many protein supplements are available through health food stores and vitamin stores. The advertisers often state that our food would be substandard and these supplements would help “to regain strength”. Athletes hope to get stronger muscles from amino acid supplements because they are the building block for protein that builds up muscles. Fact is that no supplements are needed when you eat balanced meals containing meat and fish and you exercise regularly. The protein in your food will be broken down into amino acids and your body metabolizes this into your own protein. Here is a website that reviews the subject of supplementation with amino acids.

It is clear from this that this is a rather complex problem. Vegetarians may require these supplements to replace protein for the missing meat intake. But the rest of us have to guard ourselves against overdosing with too much meat, amino acids supplements or protein supplements.

High protein diets (Atkins diet and others) have been glorified as being helpful for weight loss. But the long-term effect of such diets lead to chronic kidney damage in those with diabetes and high blood pressure as evidenced by protein leakage in the urine (called ”microalbuminuria”, Ref.4).

According to this reference the average protein requirement is 0.6 g of protein/kg body weight/day. This text comments that this would be compatible with the World Health Organization (WHO) recommendation for protein intake. For a person weighing 140 lbs. this translates into about 50 grams of protein per day. Here is a website that explains the upper limit of meat intake with the example of an 8-ounce portion of top sirloin steak.

Protein supplements have become very popular, but you need to be careful when you supplement with this that you do not get an overdose of amino acids. Amino acid profiling has been useful for physicians and naturopaths to examine deficiencies in children or adults checking for essential amino acids in the blood. However, in the industrialized countries such as the US, Canada and others the larger concern is now the overuse of meat in our food (e.g. Atkins-like diets) and protein supplements. The same amino acid screening tests will find several of the ingredients (amino acids) in these protein supplements to be too high. In this case it is imperative to stop the protein supplements to prevent amino acid toxicity.

Other supplements of concern are creatine supplementation in the sports-minded and in athletes who want to build up muscle mass. Creatine is synthesized by the liver form amino acids derived from fish and meat that is broken down into the amino acids arginine, glycine and methionine. So, there is no shortage, but athletes and sports minded people want to push the envelope and take in additional creatine that helps their energy metabolism (ATP production) in the muscles to increase their performance (Ref. 5) Creatine is vital for the brain, the heart, the kidneys and the eyes (retina). It is a buffer for lactic acid during anaerobic exercise. Some of the side effects are muscle cramps, diarrhea, fluid retention and kidney failure when exposed to high heat and dehydration. There are no long-term studies of the use of creatine supplements, yet some athletes are taking them long-term.

Conclusion:

We are tempted by various merchants and infomercials to take in more and more vitamins and supplements including protein and amino acid supplements. But when you eat well-balanced meals, preferably organic food, you already have enough protein, nutrients, calcium, vitamin C and vitamin A contained in food. So you may be inadvertently putting a strain on your kidneys that have to eliminate whatever it is that is too much for your body to take. Your liver may also be quietly working overtime as well. Your brain gets overactive by the surplus of amino acids that are utilized by the brain to make brain hormones. Your system can only take so much; at one point a surplus of supplements will make you sick! So, be vigilant and think about what your regular food intake already provides. Do you really need that supplement or do you already get enough from your food intake? Are you falling for some marketing scheme? Remember, you are the steward of your own health!

It is true that sweets are not good for you because they lead to fat accumulation and to diabetes. I explain how this works later in this blog. But who says you cannot sweeten your life with healthy ingredients? Not all sugar substitutes are the same; some are awful, some are in between and one is good (see below).

General information why sweets and starches are bad for you:

There is a triple whammy from sweets that you don’t really want:

a) First, sugar gets absorbed really fast through the gut wall and arrives in your blood stream within 15 to 20 minutes. Starches can be just as powerful in terms of blood sugar surges, but it takes perhaps 30 to 40 minutes for the peak of blood sugar to occur. The end result is the same: whether you load up with a pizza, a doughnut or drink a large, sugar-loaded soda drink, your pancreas reacts the same way. It produces a lot of extra insulin to bring the blood sugar level down. When you do this day after day your pancreas gets used to overproducing insulin and you develop insulin resistance meaning that your insulin receptors that are on every cell surface get tired and become less sensitive to insulin. Due to insulin resistance the muscle cells and the liver cells do not take up sugar (in the form of glucose) as easily as before.

b) Second, because excess sugar cannot be stored as glycogen (the storage form of glucose in the liver and the muscles), the liver converts excess glucose into triglycerides and oxidized fatty acids get taken up by white blood cells called macrophages. These attach to the inner lining of the arteries and lead to atheromatous plaques, the first stage of hardening of the arteries.

c) Third, glucose is an oxidizing agent that will oxidize LDL cholesterol. This makes the LDL particles much denser and forms the so-called very dense LDL lipoprotein fraction (VDLDL) that can be detected in special blood tests (Ref.1).

Not surprisingly people who consume sugar, sweets, soft drinks and starches on a regular basis will have very dense LDL particles (=VDLDL, also called “pattern B-LDL”). The treatment for this is to quit sugar and starchy foods.

Many years back the food industry decided to offer alternative diet drinks that would not contain sugar, but instead have aspartame in it.

Dr. Blaylock has researched excitotoxins like MSG and aspartame (NutraSweet) and urges you in this link to abandon both. I agree with him. But while we are at it, don’t take other artificial sweeteners like sodium cyclamate in Canada (Sweet’N Low). Are you thinking of taking sucralose (Splenda) instead? Think again. What the industry seems to have forgotten is that it was originally developed as an insecticide. This website states that sucralose was actually discovered while trying to create a new insecticide. A researcher tasted it and found it exceedingly sweet. I have done the experiment myself in Hawaii where small ants are ubiquitous. I thought I take a package of Splenda from a coffee shop and do the experiment: In the beginning the ants were reluctant to eat it, but after a few hours they came and took it in. One day later there were only shrivelled up dead ants left in the area where Splenda had been sprinkled. Proof enough for me that Splenda was developed as an insecticide!

In the Splenda marketing scheme they decided to first introduce Splenda gradually into diabetic foods as a sweetener, then later sell it to the public at large. Don’t fall for it. It was a side product of insecticide research, and insecticides have the undesirable quality of being xenoestrogens, which block estrogen receptors in women. As a result of that estrogen can no longer access the body cells, including the heart. The final consequence for a woman is a higher risk for cardio-vascular disease. This can cause heart attacks, strokes and cancer. In men estrogen-blocking xenoestrogens can cause breast growth and cause erectile dysfunction.

The natural sweeteners:

One wonders why the food industry did not choose healthy sweeteners like stevia that has been used for decades in Japan and South America.

Other sweeteners like xylitol, sorbitol, maltitol, mannitol, glycerol, and lactitol are sugar alcohols. Contrary to what many believe they have calories, but much less than sugar, so they are perceived as “safe” as a dietary supplement for weight loss. These alcoholic sugar compounds still produce partial LDL oxidization; interfere with weight loss and still lead to a certain insulin response. Stevia, a natural sweetener from a leaf of South America is safer and without any calories.

The key is that stevia will not oxidize your LDL cholesterol and will not cause a hyperinsulinism response following a meal. It is metabolically neutral. It is the ideal sweetener for people who desire to lose some weight. It is also safe as it is no excitotoxin. The FDA has recognized stevia as “generally recognized as safe” (GRAS).

The problem is that they are all sugars, which cause a full insulin response leading to obesity, diabetes and hardening of the arteries. This causes heart attacks and strokes. These natural sugar products also oxidize LDL cholesterol, which initiates plaque formation as discussed above; this is the first step leading to hardening of the arteries. It took the medical profession 30 years of observing that a low fat/high carb diet makes us fat and causes heart attacks, leads to strokes and causes diabetes. Let’s not make the mistake of trusting the food industry and mindlessly swallow so-called natural other sugars and sugar substitutes like xylitol, sorbitol, maltitol, mannitol, glycerol, and lactitol. You may want to chew the odd gum with xylitol, as this will prevent cavities in your teeth. But otherwise it is much safer to just stick to Stevia to sweeten your tea, coffee or food. There are brands that are less bitter than regular stevia products, like stevia from New Roots in Canada and stevia from KAL in the US (no, this is not a commercial, it is based on my own observations).

Conclusion:

Sugar is an emotional topic that can get people caught up in heated discussions. The sugar industry and the sugar substitute industry have also powerful lobby groups that provide the Internet and the popular press with conflicting stories to convince you to buy their product. This blog was meant as a no-nonsense guide to get you removed from the high-risk group of candidates for heart attacks, strokes or diabetes. Let’s not forget the metabolism behind the various sugars and starchy foods described above, which I have explained in more detail in my recently published book (Ref.2). Forget the emotions of severing yourself from your favorite fix and stick to a tiny amount of stevia that can replace the familiar sweet taste that you have become accustomed to from childhood onward. At least this is what I do. The only alternative would be to take the plunge and cut out any sweet substance altogether, which I am not prepared to do. If you can do it, by all means go ahead.

Lovastatin (Mevacor, from Merck) was the first statin drug approved by the FDA in 1987 as a cholesterol-lowering drug in the US. It made history in helping high-risk heart attack patients reduce their cholesterol levels and has helped safe many lives. But with the detection around 2002 that heart disease is an inflammatory disease, and that measuring the C-reactive protein with a blood test was a better than measuring cholesterol levels in predicting who would be at risk for developing a heart attack, the landscape has changed. Lifestyle changes have also been shown to be very effective in reducing cholesterol, C-reactive protein and triglyceride levels. In fact, lifestyle changes will reduce the risk for heart attacks and strokes. The newest flurry of activity with calls for putting more people on statins (see this recent news article) makes me suspicious that there could be a misrepresentation of the facts.

In this blog I am analyzing the literature to get to the bottom of the facts on reducing risk for heart attacks and strokes. I also come to my own conclusion.

Facts about cholesterol

Cholesterol is a waxy substance that is part of the cell walls and plays a vital role in our metabolism. Liver cell membranes, for instance contain about 30% cholesterol. However, most of the cholesterol in our body comes from metabolism, 20 to 25% from the liver, the rest in the gut, adrenal glands and the reproductive organs, and also from the brain (the myelin sheaths contain a lot of cholesterol). 50% of the body’s cholesterol is recycled through bile salts and reabsorption of cholesterol in the gut (called the enterohepatic pathway).

Cholesterol is vital for cell function, for insulation of nerve fibers (myelin sheaths) and for synthesis of our steroid hormones (sex hormones and vitamin D3, which is now considered to be a hormone). The medical establishment took most of the information regarding heart attack and stroke prevention from the ongoing Framingham study. This clearly pointed to the importance of lowering the LDL cholesterol fraction (the “bad” cholesterol) and maintaining or increasing the HDL fraction (the “good” cholesterol). When it was realized that concentrating only on lowering cholesterol missed 50% of all heart attacks that researchers refocused and found the missing link, namely inflammation. Inflammation is at the cause of heart attacks and strokes, high cholesterol and lipids were only secondary phenomena. Ref. 2 points out that a comprehensive approach to treating a patient with high cholesterol should involve a combination of treatments aimed at the underlying risk factors for heart disease or stroke in a particular patient. This involves sophisticated blood tests where a metabolic derangement can be pinpointed. It should include measuring cholesterol fractions, lipids, the C-reactive protein, hormone levels and more.

Statins Can Hurt The Consumer

How the traditional thinking about cholesterol has changed

The Framingham study has provided the basis for the drug industry to produce statins until about 2002 when our thinking about cholesterol being the culprit for causing heart attacks has forever changed. Subsequently further research showed that other factors like inflammation of the blood vessels, the metabolic syndrome associated with obesity and lack of exercise were also to blame for causing heart attacks and strokes. Recently more details have come to light, which point to multiple causes like the consumption of too much sugar, too much trans fats, too much salt and eating too much over processed convenience food. We end up gaining weight, develop the metabolic syndrome and inflammation of arteries (including the coronary arteries of the heart and the brain vessels). It is the lack of nitric oxide in the lining of the arteries, which combined with inflammatory substances from visceral fat are responsible for hardening of the arteries as the ultimate consequence of faulty nutrition and lack of exercise. We also know that oxidized LDL, particularly the very low-density lipoproteins (VLDL), will release free radicals and damage the arterial walls. CoQ-10 is a supplement, which is known to counteract this. One important test that had developed out of the Framingham study is the “ratio of total cholesterol to HDL cholesterol”, which is used by cardiologists to determine the risk of coronary artery disease. The average risk of this ratio for Americans is 5.0 for males and 4.4 for females. The ideal ratio to strive for is the “1/2 average risk” ratio of 3.4 for males and 3.3 for women (Ref.2). A fit, slim person who eats a low carb, normal fat diet (modified Mediterranean diet) will often have a ratio of only 3.0, well below the 1/2 average risk. The moment you introduce grains in your diet (cereals, bread, pasta) your liver will convert carbs into LDL cholesterol, while HDL cholesterol will drop resulting in a high risk ratio of above 5.0 (often 7 or 8 or more). The LDL will get oxidized and is deposited into your arteries setting you up for coming down with a heart attack or stroke down the road.

How do statins work?

The statins are a group of drugs that inhibit an enzyme, called the hydroxymethylglutaryl–Coenzyme A (HMG-CoA), which leads to a lowering of cholesterol, specifically a fraction known as the LDL cholesterol. The success story of lovastatin (Mevacor) led to a flurry of new HMG-CoA reductase inhibitors (cholesterol lowering drugs) such as fluvastatin (Lescol), pravastatin (Pravachol), simvastatin (Zocor), atorvastatin (Lipitor), and rosuvastatin (Crestor) in the late 1980’s and the 1990’s. Collectively it is now a 26 billion industry in annual sales.

Later investigations showed that there were other mechanisms by which statins helped, namely they were found to decrease the inflammatory reaction, which can be measured by lowering of the C-reactive protein. However, there are significant side effects in about 1 to 3% of people who take this medication, particularly an inflammation of liver cells (evident from elevation of liver enzymes) and a myopathy, which is a painful muscle condition (Ref. 1). This latter fact, which can occur in as many as 33% of the population at large (particularly the exercise minded) has limited the use of statins in competitive athletes where myopathies can occur in as many as 75% of athletes treated with statins (Ref.2). The reason for that is that the muscles of athletes cannot keep up with the demands put on them when they are kept in check by the HMG-CoA reductase inhibitors. On the other hand statins have prevented heart attacks and deaths from heart attacks and strokes in about 25% to 35% of patients treated with them as many clinical trials have shown (Ref.1), but simple supplements that have no side effects can do the same or do even better (see below).

The lack of cholesterol synthesis by the body’s cells when statins are given, leads to an expression of more LDL receptors on the cell surfaces. LDL binds to these receptors and enters the cells, which removes the circulating high risk LDL fraction of cholesterol from the blood thus causing a drop in LDL cholesterol. All of the side effects of statins (pull down to side effects in this link) can be explained as a result of the slow-down of organ functions (brain, muscles, gut, adrenal glands, etc.) as cholesterol synthesis is reduced.

New information from the Framingham Heart Study

So far everything I said made sense. But when I came across Ref. 4 I noticed that there was a bombshell of new information from another follow-up study of the Framingham Heart Study (Ref. 5) that did not fit in with the latest marketing drive of the statin manufacturers. In this study from 2005 Boston researchers had studied the outcomes of 789 men and 1105 women over a period of 16 to 18 years with respect to cognitive function. Participants were divided into total cholesterol groups that showed levels that were desirable (less than 200), borderline (200 to 239) or high (above 240). The astounding results were that higher cognitive functioning as documented in multiple cognitive tests in these three groups showed the best performance in the group with the highest cholesterol and the worst cognitive test outcomes in the lowest cholesterol group, quite opposite of what was expected.

Another important piece of research (April 2013) comes from Spain where doctors followed a group of 7447 patients with a high cardiovascular risk who were put on a Mediterranean diet with olive oil, a Mediterranean diet with nuts or a regular diet. The end point was death from heart attack or stroke. After 4.8 years the study had to be interrupted as the Mediterranean groups showed a significant survival advantage over the group on a regular diet.

Ref. 4 cited literature evidence that statins cause a 48% increased risk in postmenopausal women who take statins to develop diabetes. It also cites compelling evidence that diabetes patients are twice as likely to develop Alzheimer’s disease within 15 years and are 1.75 times more likely to develop any kind of dementia in the same time period.

Dr. Seneff from the Computer Science and Artificial Intelligence Laboratory at MIT explains in great detail that statins effectively reduce cholesterol synthesis in the liver, which in turn starves the brain of one of its main nutrients explaining why patient develop Alzheimer’s disease and dementia as a result of statin treatment.

So, the lessons to be learnt from these clinical trials are that you want to offer your brain enough cholesterol and healthy fat to have a normal metabolism. Fortunately, what’s good for your heart is also good for your brain. Conversely avoid statins, if you can and try alternatives first. Ref. 4 explains that for years the experts had the wrong theory that low fat/high carb was what would be good for your heart and brain, but the opposite is true: what is good for your heart and brain is a high healthy fats/low refined carb diet.

Make sure that with your blood tests that fasting insulin is low (no insulin resistance), that the ratio of total cholesterol to HDL cholesterol is less than 3.4 (low risk for heart attacks or strokes) and that the hemoglobin A1C level is low (4.8 to 5.6%, ideally less than 4.5%), which means you are not diabetic.

How alternative treatment can save you from heart attacks

Lifestyle treatment through dietary intervention, moderate exercise, and weight loss has been somewhat neglected by mainstream medicine, but is now recognized in regular textbooks of medicine as first-line treatment (Ref. 3). Most patients can lower LDL cholesterol by 10 to 15% through a change in diet. High-risk patients with established heart disease (narrowing of coronary arteries) require a drop of 30 to 60% of LDL cholesterol; this high-risk patient group may need an addition of a statin. In patients with metabolic syndrome or diabetes high triglycerides are often present and will respond to decreased intake of simple sugars, alcohol, and calories (Ref.3). Total calorie intake should be adjusted according to what the weight is when weighed every day with the goal of reducing the weight when overweight or obese, but maintaining the weight when it is in the normal body mass index range (BMI of 20 to 25). The total fat intake should be around 25%-35% of the total calorie intake. Specifically, saturated fat needs to be less than 7% of total calories, polyunsaturated fat up to 10% of total calories and monounsaturated fat up to 20% of total calories. Healthy fats according to Ref. 4 are extra-virgin olive oil, organic butter, almond milk, avocados, olives, nuts, nut butters and cheese ( except for blue cheeses). Other healthy fats are sesame oil, coconut oil, and the oils found in seeds like flaxseed, sunflower seeds, pumpkin seeds and chia seeds. Note that trans-fats (such as in margarine and baked goods) are a “no-no” as it causes free radicals in your body, which would accelerate the hardening of your arteries. Complex carbohydrates from vegetables and fruit are the main source of total calories providing 50%-60% of the total calories. Fiber intake needs to be 20-30 grams per day. Protein intake should be about 15% of total calories. Fat should provide 25% to 35% of the total calories per day. Cholesterol intake should be less than 200 mg per day. You may want to consider the use of plant sterols (2 grams per day) to enhance LDL cholesterol lowering. Physical activity from moderate exercise should expend at least 200 kcal per day (better 300 kcal).

Which supplements prevent heart attacks and strokes?

There are several nutrients that have been shown to be powerful preventers of heart attacks and strokes. I will review them briefly here (based on Ref. 2):

1. Coenzyme Q10 (CoQ10): The cells lining the arteries are only working well when their mitochondria are working properly producing chemical energy in form of ATP. CoQ10 is an important component of the mitochondrial metabolism; it is also the only fat soluble antioxidant that gets absorbed into the LDL particles where it protects these from oxidation. Statins suppress CoQ10 synthesis, so patients on statins need to take CoQ10 supplements daily to counteract this. However, anybody who is healthy now should take CoQ10 as a daily supplement for prevention. I take 400 mg per day.

2. Vitamin E (tocopherols): this fat soluble vitamin is an antioxidant and has been praised in the past as being heart supportive, was subsequently bad-mouthed by some conservative physicians, but lately has been resurrected. It turns out that there are 8 different types of tocopherols, with the alpha tocopherol being the most known, but gamma tocopherol is the one you want to make sure you are also getting with your balanced vitamin E supplement every day as this is the one that is a powerful anti-inflammatory. Simply ask staff at your health food store for a vitamin E supplement with gamma tocopherol in it. Take 400 IU per day (of the mix).

3. Curcumin: This is a powerful heart and brain protector combining three different mechanisms in one; it is reducing oxidative stress, is an anti-inflammatory and counters the process that threatens to destroy the lining of the arteries. One study on healthy volunteers showed a reduction of 33% in lipid oxidation, a 12% reduction of total cholesterol and an increase of 29% of the protective HDL cholesterol when 500 mg of curcumin was taken only for 7 days (Ref.2). This is the daily dose I would recommend for prevention of heart attacks and strokes.

4. Polyphenols: Flavonoids are the largest group among the polyphenols contained in such common foods as vegetables, fruits, tea, coffee, chocolate and wine. Over 130 studies have been done on humans showing improvement of the lining of the arteries (endothelial functioning) and lowering of blood pressure. Polyphenol consumption has been associated with a lower risk of mortality from heart attacks. Eat a Mediterranean type diet or a DASH diet and you will automatically get enough polyphenols with your food. However, resveratrol, the powerful red wine polyphenol warrants a separate daily supplementation as it prevents LDL oxidation in humans (Ref.2). Take about 250 mg of it daily.

5. Niacin/nicotinic acid: This supplement comes as “flush-free niacin” and also as extended release niacin; it can raise the beneficial HDL cholesterol by 30 to 35% when higher doses of 2.25 grams per day are used. In a metaanalysis of 7 studies it has been shown to significantly reduce heart attacks and transient ischemic attacks (precursor syndrome before developing a stroke). Niacin can change the small particle LDL into a large particle size LDL, which is less dangerous. Niacin has also been shown to reduce oxidation of LDL, which stops the atherosclerotic process. For a healthy person 500 mg per day of flush-free niacin is adequate.

6. Fish oil (omega-3-fatty acids): Because heart attacks are due to an inflammatory process and high LDL cholesterol is thought to be only a secondary phenomenon, it is very important to have this additional tool of an important anti-inflammatory supplement. In the past it was still safe to eat fish fairly frequently per week. But with mercury, radioactive iodine from Japan’s leaking reactor and carcinogenic PBC’s all congregating in the ocean waters, it is no longer safe to consume fish in large quantities. The remedy to this situation is molecularly distilled (or pharmaceutically pure) EPA/DHA supplements. EPA stands for eicosapentaenoic acid or omega-3 fatty acid. DHA is the acronym for docosahexaenoic acid. Fish oil supplements at a dosage of 3.35 grams per day of EPA plus DHA were shown to reduce triglycerides by up to 40%, equally to Lipitor or even more effective, but without the statin side effects. The amount of the dangerous small dense LDL is also being reduced with fish oil. Fish oil supplements have reduced the mortality from heart attacks and strokes and led to a higher survival from non-fatal heart attacks. At the same time these preventative fish oil doses will also treat and prevent arthritis.

7. Other useful supplements: Soluble fiber from psyllium, pectin, beta-glucans and others have been shown in clinical trials to reduce LDL cholesterol by binding bile salts in the gut (interrupting the enterohepatic pathway). Plant sterols (usually sold as sterol esters) are recognized by the FDA as reducing the risk of coronary heart disease, if taken in high enough amounts (2.4 grams of sterol esters per day). There are other useful supplements like artichoke extract, pomegranate, soy protein, Indian gooseberry (amla), garlic and pantethine (vitamin B5) that have been proven to be of benefit in terms of prevention of heart attacks and strokes. It would be too lengthy to get into more details here.

Conclusion

Recently there was a review in a medical journal that demonstrated that clinical guidelines (in this case for clinical guidelines for lowering cholesterol) erred 40% of the times when measured against scientific tests as this link explains. When it comes to saving lives by preventing heart attacks and strokes, what is needed is a multifactorial approach that treats the multifactorial causes of cardiovascular disease. Just pushing for treating more people with statins as Big Pharma is attempting to do is not addressing the fact that cholesterol is needed for our metabolism and the synthesis of our hormones. It is much superior to use a combination of different approaches that overlap and thus potentiate each other in their effects excluding statins first. Exercise creates more nitric oxide production by the lining of the arteries, which opens up arteries and prevents spasms. A proper diet with as many of the proven vitamins and other support factors will control inflammation and oxidation of LDL cholesterol particles as explained. This will prevent heart attacks and strokes as has been shown in many clinical trials. Only patients who come from families with genetically high cholesterol or high triglycerides and those patients who had heart attacks and strokes should be exposed to statins as they are at a higher risk of developing a heart attack or stroke. They need all of the help they can get in addition to the lifestyle factors mentioned. Most other patients and the public at large will do quite well without statins (no side effects of diabetes, Alzheimer’s and muscle pains). And, yes, a diet high in healthy fats, but low in refined carbs is what your brain and heart need (the opposite of what you have thought, see Ref. 4).

Osteoarthritis affects about 4 to 5% of the population with women outnumbering men by 2 to 1. The age of onset typically is less than 50 years, but becomes more evident and more disabling beyond the age of 50. About 40 to 60% of osteoarthritis is genetically linked as twin studies in women have shown (Ref.1).

Synonyms for osteoarthritis are degenerative joint disease, osteoarthrosis and arthrosis.

Till recently arthritis was accepted as something that was inevitable: people were getting old, were getting stiff and sore, and had to “take it easy” as a result when they got older. Things are not as uncomplicated, as arthritis affects about 53 million Americans, and it has become the leading cause of disability in the US.

Rheumatoid arthritis is an autoimmune disease. It is not a disease of “old age” but can affect people of every age group. The body reacts to components in joint tissue, and this immune reaction to collagen will produce inflammation, pain and ultimately disability.

So far osteoarthritis was believed to be the result of wear and tear affecting the aging population, but more recently it has been discovered that osteoarthritis is also accompanied by the same inflammatory immune factors that are involved in rheumatoid arthritis.

When the body attacks collagen, which is needed to keep the joints moving smoothly, microscopic particles of it wander into the blood stream. There they are perceived as foreign molecules, and the immune system produces inflammatory substances (cytokines). These are sending out an army of “killer T-cells” to combat the collagen, which is perceived as a foreign matter. They are bombarding the exposed cartilage with toxic substances. This means a chaotic combination of oxidative stress and more inflammation. Over time the cartilage that was meant to protect the joint in its function to move freely is eroded and destroyed. For the person suffering of this disordered reaction, it means that the joint is not only creaking but causing pain, which is made even worse by weight bearing (walking, standing). Any person suffering of osteoarthritis will complain that he or she feels stiff and sore especially after a period of inactivity.

Commercials for anti-inflammatory medication are plentiful, and many sufferers resort to the pain relief that is promised. The warnings are mentioned right after the commercial or on the medication package, if the patient reads the fine print. Most anti-inflammatory medications are causing irritation of the stomach, and the kidneys get damaged (nephropathy)with prolonged use from these pills despite the promises in commercials of a happy, active and pain free life.

Causes of arthritis

There are many varied causes that can all contribute to developing arthritis.

It is important to take a critical look at lifestyle choices. Excessive body weight puts an additional burden on the joints in the body. Increased body fat is not just sitting at the abdomen as an inert potbelly. Abdominal fat is a highly active metabolic organ that releases inflammatory substances into the blood stream, which distributes them throughout the body. It is known to damage blood vessels. Inflammation will damage the joints as well. The statistics show that 33.8 % of obese women have arthritis. The percentage for obese men shows that 25.2 % suffer of arthritis.

Smoking leads to circulatory problems, and lack of oxygenation in the body’s tissues. It is a mistake to believe that damage is done only to the lungs or the heart. The joints will be affected as well.

Mechanical stress with inadequate self-repair is one cause; misalignment of bones such as knock-knee (genu valgum) and bowleggedness (genu varum) will lead to premature osteoarthritis of the knees as can loss of muscle strength. Exercise without injury does not contribute the risk for developing osteoarthritis; it is actually part of the rehabilitation plan.

One of the newer findings is that osteoarthritis is actually an inflammatory condition where numerous destructive processes occur within the affected joints leading to a breakdown of cartilage and supportive synovial fluid factors (proteoglycans). These findings lead to the possibility of new therapeutic approaches discussed below.

Diagnosis of osteoarthritis

According to Ref. 1 there are no blood tests and analysis of synovial fluid is non-diagnostic. Diagnosis of osteoarthritis is made by history, X-rays of the affected joints and clinical findings. There are joint tenderness and swelling of the affected joints. Heberden’s nodes (swelling of the distal interphalangeal joints or DIP joints) and Bouchard’s nodes (swelling of the proximal interphalangeal joints or PIP joints) are present. There can be a decreased range of motion and a grating sound of two ends of bones rubbing together (called “crepitus”). X-rays show typical osteoarthritis details with a narrowing of the joint space of the affected joint, subchondral sclerosis (increased bone formation around the joint) and new bone formation at the joint margins, called “osteophytes”).

Integrative therapy of arthritis

Ref. 2 points out that integrative treatment of arthritis is aimed at reducing joint pain, increasing joint function and reducing further joint deterioration. Some measures are symptomatic only, others are disease modifying.

Nutrition

Dietary habits can promote good health or have disastrous consequences. The news has been out for some time that the typical North American diet with a high load of omega-6 fatty acids will stoke the fires of inflammation in the body and lead to arthritis, heart disease and cancer. Soybean oil, cottonseed oil and safflower oil contain the cheaper omega-6 oils that are widely used in food processing and bakery products. Refined carbohydrates contribute to unhealthy spikes in blood sugar levels and wreak havoc in their own way paving the downward slope to insulin resistance, metabolic derailment, and diabetes. Take a hard look at your shopping wagon. Stay away from processed foods, shop the periphery of the supermarket, and choose organic meats, vegetables and fruit. Use heart healthy fat in the form of virgin olive oil. A Mediterranean type diet will be a good choice. Just bear in mind, that a heap of pasta like Fettuccine Alfredo does not constitute what a healthy Mediterranean diet is all about. An anti-inflammatory diet such as a Mediterranean diet also includes deep-water fish as a source of omega-3 fatty acids or molecularly distilled omega-3 capsules (you need 7 to 8 high potency, molecularly distilled fish oil, 1000mg per capsule) every day.

This approach has shown beneficial effects in beginning stages of osteoarthritis.

It is important to cut out sugar and starchy foods to reduce insulin resistance, which would otherwise maintain the inflammatory chronic condition causing arthritis and cardiovascular disease. For the same reason cutting out wheat and wheat products has been shown to be beneficial in reducing inflammation. Such an anti-arthritis diet prevents heart attacks and strokes at the same time.

Weight loss

Ref. 2 points out that one study showed that weight reduction of only 10% had a 28% improvement in joint function. When this is combined with an exercise program the improvements are even more striking.

Exercise

Exercise consists of aerobic training, resistance training and muscle strengthening. When patients with osteoarthritis were observed throughout controlled exercise programs, flexibility and range of motion of the affected joints were improving. A minimum of three days per week of exercise was required to show improvements, but the best effects were observed when patients exercised most of the days. Joints become less swollen, show improved circulation and less pain. Before an exercise program is done, those with increased cardiovascular risk should first undergo an exercise stress test to measure their cardiovascular reserve and establish that it is safe to start a program. Secondly, an acutely inflamed or swollen joint should first be treated before an exercise program is started. Lack of exercise will promote more disability. While a person with arthritis may be unable to run a brisk race due to joint discomfort, he or she will find water exercises and swimming much more manageable. Group programs for people with arthritis are available and you may enjoy the supportive company.

Heat and cold therapy

Ref. 2 points out that three weekly 30 minute sessions of microwave diathermy for 4 weeks showed a significant reduction of joint swelling in knee osteoarthritis with improved joint function and reduced pain. On the other hand cold packs for aching muscles after strenuous exercises can decrease muscle spasm and increase the pain threshold. Range of motion increased with cold application and joint swelling was reduced. Patients who have cold sensitivity (such as Raynaud disease) need to refrain from the latter treatment modality.

Acupuncture and electro acupuncture

These treatments were found by Ref.2 to be useful as an adjunct to anti-inflammatory medication with NSAIDS (non steroidal anti-inflammatory drugs); the advantage was that the dosage of NSAIDS could be reduced, which reduced the potential serious side effects of gastric bleeds and kidney damage. Note that people with pacemakers or CNS stimulators cannot use electro acupuncture.

Intraarticular steroid injections

When only a few joints are affected by osteoarthritis (or rheumatoid arthritis), a physician can inject a corticosteroid into the joint. However, there are limitations, as each joint should not be injected more than 3 to 4 times per year. Otherwise there can be damage to the joint cartilage, which would make the arthritis worse. However, I have seen surprisingly good results for a long period of time, which allowed the patients to exercise and stabilize the joints that way.

Complementary treatments

A number of supplements and herbs are effective in reducing inflammation. Omega-3 fatty acids are the precursors for anti-inflammatory prostaglandins in the body, which helps both patients with osteoarthritis and rheumatoid arthritis. As indicated under nutrition above, higher doses are required for this effect and for safety (avoiding toxicity from mercury and PBC’s) molecularly distilled omega-3 fatty acid supplements should only be used (yes, they are more expensive).

Curcumin, the active ingredient of the spice turmeric, has been used in India and Asia for its anti-inflammatory and antioxidant properties for centuries. It helps not only arthritis, but also helps also against the illnesses that are often associated with it (obesity, diabetes, heart disease, autoimmune conditions). Ref. 2 points out that curcumin neutralizes inflammatory agents circulating in the blood of patients with arthritis.

Other common supplements for building up cartilage in the joint are glucosamine sulfate and chondroitin, both available at the health food store. They stimulate glycosaminoglycan formation, which in turn builds up hyaline cartilage, the enamel-like coating of the bone within the joint.

An oral desensitization to treat arthritis

Can joint health be helped in other ways? New answers have emerged. In the past, people who were suffering with colds or flus were consuming a steaming bowl of chicken soup. It should be mentioned that colds and flus are also an inflammatory reaction that occurs within the body.

While a lot of health professionals dismissed this home remedy as old-fashioned and useless, a team of scientist from the University of Nebraska decided to research the matter a bit closer. They discovered that it was not the vegetables, but a component in the chicken broth that showed anti-inflammatory activity. The chicken derived type II collagen functions to regulate the immune system, so it stops attacking proteins normally found in healthy joint cartilage. Results of a pilot study have shown remarkable results. A dose of 40 mg per day of un-denatured type II collagen (UC-II) showed a significant reduction in pain and swelling from arthritis. It also yielded good results in terms of relief from joint pain and stiffness due to exercise.

Animal studies on dogs and horses were also conducted demonstrating that both animal groups that frequently suffer from arthritis got significant relief. Human clinical trials with UC-II showed similar effectiveness.

A group of patients suffering from knee osteoarthritis were treated with the supplement for 90 days. 33% experienced a reduction in their osteoarthritis. The pain was reduced by 40%. Those patients who received the standard treatment without any supplement had 15.4% less pain. Joint function was improved by 20% in the group taking the supplement, while only 6% of improvement was seen in the patient group receiving standard care.

Healthy patients were also assessed who did not suffer of arthritis, but received the supplement to evaluate how they would fare with exercise-induced knee pain. They were treated with a daily dose of 40 mg of UC-II. After day 90 and 120 the group that was treated with the supplement could exercise for significantly longer periods before experiencing joint pain. They also recovered faster after joint pain. The placebo group who swallowed “fake pills” did not show these changes. When knee joint flexibility was examined, the supplement group had significant increases in their knee mobility, but no luck for the placebo group!

Numerous toxicological essays have evaluated the supplement. There is no oral toxicity. No mutations in bacterial genomes have been observed, which is a standard screen to ensure that a substance is non-carcinogenic.

The UC-II supplement works through a mechanism, where the immune system is desensitized by ways of oral administration. It reverses T-cell attacks on exposed cartilage. If our joints are healthy and intact, we normally do not react to our own cartilage. But the protective barrier between blood and cartilage diminishes as we age. Early treatment with UC-II may help induce immune tolerance even in healthy individuals and protect them from reactions of the immune system to their own cartilage.

Conclusion

The supplementation with UC-II offers a different approach to modify joint inflammation of arthritis. Standard treatment at this point consists mainly of symptomatic treatment. Side effects to the drugs can be serious, if they are used on a long-term basis. Few are tolerable to modify the course of the disease.

With the UC-II supplement the root of the disease (autoimmune disease) is being addressed, and relief can be achieved within a few weeks of starting it. With life style changes that were mentioned before and this supplement it is possible to fight back against arthritis!

90% of all diabetes cases are due to type 2 diabetes, which is associated with being overweight or obese. The other 10% are due to type 1 diabetes, which is caused by an autoimmune disease within the pancreas destroying the insulin producing beta cells. Diabetes, type 1 often occurs in childhood (hence the name “juvenile diabetes”), while type 2 diabetes is a condition of the middle aged and older population. There is however an alarming trend: overweight or obese youngsters are also being diagnosed with type 2 diabetes. Here I am discussing type 2 diabetes.

Causes that trigger diabetes

There is not just one way to get diabetes; it usually is a multifactorial disease. Sure, genetics play a minor role. But you need to have epigenetic factors to trigger the genes to develop diabetes: eating too much sugar, eating wheat and wheat products, drinking soda drinks that contain sugar or high fructose corn syrup. Alcohol binges can also cause diabetes as can accumulation of excessive weight (a body mass index above 25.0). Even when there is no genetic risk in your family (your family tree has nobody that came down with diabetes and all your ancestors lived into their 90’s), you can still develop diabetes, if you are exposed to one or more of the risk factors mentioned.

What is the reason why diabetes occurs?

At a Keystone Symposium from Jan. 27 to Feb.1, 2013 in Keystone, Colorado (Ref.1) leading scientific researchers gathered to discuss exactly this question. There seem to be several mechanisms, all of which lead to diabetes. It has been known for some time that in type 2 diabetes insulin resistance develops that renders the cells incapable of absorbing blood sugar (glucose) from the blood into the cells. It is because of this insulin resistance that doctors can diagnose diabetes when blood sugar levels are high.

Successful Diabetes Treatment Requires Patient’s Discipline

There are at least 5 mechanisms that are presently known that can cause insulin resistance (and thus diabetes) by itself or in combination. For a deeper understanding of diabetes it is crucial to be aware of these. Without knowing the enemy, you cannot fight it.

1. When a person eats too much sugar or fructose the liver converts this into excessive fat that is accumulated in the body’s cells. As a result insulin receptors are becoming inefficient in absorbing sugar from the blood, and blood sugar levels stay high. The pancreas reacts to this by making even more insulin, which after a few years will cause the pancreas to fail in producing insulin. At this point the patient requires insulin or else gets into a diabetic coma.

2. Chronic inflammation is another mechanism that has been shown to cause insulin resistance. Obesity, the metabolic syndrome and diabetes have a common inflammatory denominator that results in insulin resistance. With the aging process there is also deterioration of mitochondrial function (mitochondria are the mini batteries inside of every cell that are responsible for you having energy). This causes fat accumulation and also insulin resistance. Exercise and weight loss are effective in combatting insulin resistance. Fasting has also been shown to improve insulin sensitivity.

3. The metabolism of visceral fat (the type of fat causing the apple appearance in obesity) is highly active and is associated with an increased risk for heart attacks and developing diabetes. The pear shaped woman runs less of a risk, as the fat around the hips is not metabolically active. On the other hand when these women enter into menopause, they also develop abdominal fat (apple-like fat distribution) with a high secretion of inflammatory substances causing insulin resistance, heart attacks and strokes.

4. Another mechanism of causing inflammation comes from invasion of organs with fat cells. The development of fat toxicity from these displaced fat cells can also cause insulin resistance. Heart cells have been shown to die from fat toxicity and in the pancreas the insulin-producing cells can be killed by fat toxicity as well causing diabetes or making existing diabetes worse.

5. Interestingly another line of research, namely researching binge drinking, has revealed that there is a short-term insulin resistance that lasts for several days until the alcohol has been properly metabolized. It is of concern that adolescents who are experimenting with binge drinking are very vulnerable to develop brain damage from this habit.

Consequences of insulin resistance

We know that insulin resistance is the cause for adult onset, type 2 diabetes. It is entirely preventable. But there are powerful influences on people’s lives that will allow one or more of these factors mentioned to cause diabetes. The most common cause is putting on excessive weight. The reason for this is that people like to eat fast foods, drink sugar-containing sodas, and feast on processed foods, bagels and cookies. The end result is a change of the metabolism with an increase in triglycerides from the liver, an increase in LDL cholesterol, particularly the very low-density lipoprotein sub fractions of cholesterol. It has been known for some time that this is the connection to the high, premature death rates from heart attacks in diabetics, in people with obesity and in people with the metabolic syndrome. Hardening of the arteries is accelerated by the deposition of foam cells in the walls of arteries. These are scavenger cells (macrophages) that have engulfed noxious fats. This leads to narrowed coronary arteries and also a general narrowing of arteries all over the body including the brain vessels. In diabetics hardening of the arteries is accelerated and leads to premature strokes, heart attacks and heart failure, kidney failure, blindness and amputations of limbs.

Important tests for borderline diabetics

I you have a fasting blood sugar that is above 100 mg/dL (5.5 mmol), but less than 126 mg/dL (7 mmol) you are considered to be prediabetic or “borderline diabetic”. In this case rather than waiting for disasters in terms of cardiovascular disease, take action and ask your doctor to do the following three tests.

a) Arrange for a glucose tolerance test where you are given 75 grams of glucose; then blood tests are taken at one, two and three hours after this challenge dose. These blood tests are checked for blood glucose levels and insulin levels and tell the doctor exactly what is going on in terms of your sugar metabolism. It shows the glucose clearance and also the insulin response from your pancreas.

b) Have a hemoglobin A1c test done: it shows how your blood sugars have been controlled over the last 2 to 3 months.

c) You also need a VAP (vertical auto profile) test, which tests your lipid profile. Both prediabetics and overtly diabetics have been shown to have lipid profile disorders. Apart from low values in sub fractions of HDL cholesterol this test will also measure the very-low density lipoproteins (VLDL), which has been shown to be responsible for heart attacks and strokes.

With these three tests your doctor can tell you more accurately what treatment protocol you require to succeed in controlling or curing your pre diabetes or diabetes.

Conventional treatment of diabetes

The conventional treatment of diabetes is to send the patient to a dietician, to ask the patient to do regular exercises and to either start them on hypoglycemic drugs or on insulin injections. Unfortunately the dietician often will encourage the patient to eat “healthy multigrain bread”, which will stimulate your taste buds to eat more sugar, high fructose corn syrup and starchy foods making weight loss impossible. Often the treating physician is satisfied that a hemoglobin A1c of 7% or less is good enough for the diabetic. But non-diabetic people have a hemoglobin A1c of 4% and 5.6%. This should be your goal or you will suffer the consequences of uncontrolled diabetes.

This is what I would call the conventional, symptomatic treatment approach. This may be the approach for patients who are not willing to seriously change their lifestyles, but it is more powerful on the long-term to treat diabetes by treating the underlying causes.

Alternative treatment approach for diabetes

Based on the above discussion regarding the various causes of insulin resistance, it is important to analyze what would be the main contributory factors in your particular case of diabetes.

Here are some suggestions:

1. If you are on the typical North American diet, also known as Western diet, it would be important to face the fact that wheat, wheat products in processed foods and sugar including high fructose corn syrup are the main culprits in stimulating your appetite and making you a sugar and wheat addict. Ref. 2 describes this in detail and offers 150 recipes to overcome this addiction. For more information just follow this reference text. Essentially it is a wheat-free Mediterranean type diet without rice, pasta and bread. You will shed significant amounts of pounds within a short period of time and feel a lot more energetic (due to revitalization of your mitochondria). At the same time insulin resistance is disappearing, because the insulin receptors are fully functional again. The insulin production of the pancreas will go down to normal levels and fat from the visceral fat storage gets melted away resulting in less inflammatory substances circulating in your blood.

2. A regular exercise program in a gym with an aerobic component (30 minutes of treadmill for instance and 20 to 30 minutes of isometric machine exercises) will help you to lower the triglycerides, and increase the healthy HDL cholesterol. It will also improve insulin sensitivity and control inflammation in your body. The best is to exercise 7 days per week. Remember your body works for you 7/7 every week, but for those of you who need a little rest in between 5 days per week is still very good. You may have to adjust your medication and insulin dose downwards, ask your physician about that.

3. Cut out alcohol. This may sound radical to you, but studies show this to be true. I have not mentioned cutting out smoking (it is causing inflammation and insulin resistance), because this is an absolute must that is given. When it comes to alcohol, the famous 1 drink per day for cardio protective purposes may not show up statistically as a bad effect, but your body will nevertheless get the message and let you age somewhat faster than a person who stays sober all the time. Staying sober will allow your brain to think clearly and adhere to your overall lifestyle approach in treating diabetes. Cutting out alcohol protects your brain (including the hypothalamus), liver and pancreas and prevents the prolonged periods of insulin resistance mentioned above that last for days. By keeping your hypothalamus in good working order, your hormone balance will stay stable for as long as possible until you reach menopause (for women) or andropause (for men). When you reached this milestone, I suggest you engage in bioidentical hormone replacement, which I have reviewed here. Hormones are essential to keep you younger for longer.

4. It is useful to monitor your blood sugar with a home glucometer, as this will show you when your blood sugar normalizes. Stay in touch with your doctor at all times, as this will help you in your overall management of your diabetes. Also, you will want to discuss with your doctor that you should have a blood tests called “hemoglobin A1c” measured every three months to see how well your diabetes is controlled. It should be below 7% for sure, but better below 6%. Non-diabetic people have levels of 4% and 5.6%. You may not know that hemoglobin A1c is actually measuring the amount of advanced glycation end products (“AGE”) of red blood cells. These AGE substances essentially are firmly bound sugar/protein compounds that shut down the cell metabolism wherever they are formed. In my opinion it is best to aim at a hemoglobin A1c level of non-diabetic people (4% and 5.6%) to avoid the consequences of tissue damage of all vital organs, which is the reason why long-term diabetics have a life expectancy of 15 to 20 years shorter than non-diabetic persons. Some diabetic patients may benefit from the oral hypoglycemic drug, metformin (brand name: Glucophage), which has anti-inflammatory properties and is used in patients with type 2 diabetes and a high fasting insulin level, but this is a decision requiring your physician’s input.

5. Supplements: There are some supplements that are useful to take as an adjunct, like chromium, which helps insulin to transport glucose into the cell; alpha-lipoic acid, an antioxidant, which is useful to prevent glycation (formation of a complex between sugar and protein, which prevents normal cell functioning); and coenzyme-Q10, which supports your heart (A4M recommends 400 mg per day, higher than Dr. Weil’s link). Other supplements of merit are curcumin, cinnamon, genistein and silymarin (standardized extract of milk thistle), which suppresses a pro inflammatory molecule, which in turn helps to fight insulin resistance (Ref. 1). Omega-3 fatty acid supplements are anti-inflammatory and will improve insulin resistance as well (dosage 1000mg or more per day). According to Ref. 3 vitamin D3 is useful as a supplement for diabetics, because it activates DNA, is involved in cellular repair and deficiency of it is known to lead to higher mortality rates in diabetics. Ref. 3 recommends between 1000 and 4000 IU of vitamin D3 daily and suggests doing blood tests to measure effective vitamin D3 levels (keep 25-OHD in the blood between 30 and 80 ng/mL).

6.Patients whose pancreas no longer produces insulin will need insulin injections, but instead of using long-acting insulin once per day the best results in getting blood sugar control is by injecting insulin three or more times per day using short acting insulin. It is important to always monitor the blood sugar lowering effect by glucometer readings; the injections are best given just before meals (recombinant human insulin is the preferred insulin to be used). Ask your physician or diabetic coach for more details.

Conclusion

Diabetes used to be a dreadful disease that caused premature heart attacks, strokes, blindness, kidney failure, and limb amputations. With aggressive management of diabetes as well as strict lifestyle intervention this has changed. A diabetic who treats the causes of the illness can have a normal life expectancy. In many cases the initial diagnosis of type 2 diabetes can disappear, when treatment was started early enough and insulin resistance could be stopped in its tracks. Without the patient’s full co-operation disciplining him/herself to follow through on all of these recommendations the caregiver will fail in controlling the patient’s diabetes. It is the patient who owns the problem; it is the patient who needs to make every possible effort and follow through on all of the details of dieting, exercising, blood sugar monitoring using a glucometer and taking the required supplements.

Any general practitioner knows that fall and winter are the time when patients come in with a variety of complaints like a lack of energy, problems sleeping, inability to cope with stress, but often there may be non-specific pains like muscle spasm in the back, the shoulders, or indigestion. These symptoms can all be part of seasonal affective disorders (SAD) like depression, the winter blues, often coupled with anxiety.

Emotional health does not fit easily into our health care model. The receptionist will warn the doctor that this is going to be a “difficult” patient. If the doctor has only time for a 5 or 10-minute visit, where only one or two problems can be dealt with, then this does not fit when a patient with SAD has a problem concentrating, falling asleep, and presents with a long list of other complaints. Even 20 minutes or 30 minutes may not be enough to deal with this patient adequately. It is easier to send the patient for tests and to prescribe an antidepressant and a sleeping pill and reschedule for a follow-up appointment. But this likely will result in normal blood tests and investigations, added health care costs, but no solution to the patient’s problem when he or she simply states “doctor, I feel so sick”.

I thought it would be interesting to review how our emotions can get out of balance and review an integrative approach to SAD.

Definition of SAD

Seasonal depression (also called seasonal affective disorder) occurs during fall (autumn) and winter, but this alternates with no depressive episodes during spring and summer. A person defined to suffer from SAD would have suffered from two major depressive episodes during the past 2 years with no depressive episodes in the intervening seasons of spring and summer (Ref.1). Alternative names for SAD are winter depression and wintertime blues. Typically SAD lasts about 5 months.

Brain hormone disbalance

Around 2002 it was detected that in mice there was a second light sensitive pathway from ganglion cells in the retina that were responsible for circadian hormone rhythms. This was later confirmed to be true also in humans, where photosensitive retinal ganglion cells buried deep in the retina and containing the pigment melanopsin absorb blue light in the visible light spectrum. The electrical signals are sent along the retinohypothalamic tract, so that light from the retina regulates the hormone circadian rhythm (daily hormone fluctuations including the sleep/wake cycle) in the hypothalamus. The hypothalamus is one of the major hormone centers in the center of the brain. As this publication shows there are minor genetic sequence changes for the retinal photopigment, melanopsin in patients with SAD. This affects about 1 to 2% of the American population. Many more have probably partial defects in the function of this pigment.

When the sun goes down, melatonin is produced making us sleepy. In the morning serotonin production goes up and stays up all day, which normally prevents depression. There are other hormones that cycle during the course of the day. Cortisol is highest in the morning and low in the evening and at night. Growth hormone and prolactin are highest during sleep.

There is a lack of serotonin in the brains of patients with SAD and depression.

Symptoms of SAD

A person affected by SAD or any other patient with ordinary depression will present with symptoms of lack of energy, with tearfulness, negative thought patterns, sleep disturbances, lack of appetite and weight loss and possible suicidal thoughts. On the other hand symptoms may be more atypical presenting with irritability and overindulging in food with weight gain. Some patients somaticize as already mentioned in the beginning of this review experiencing a multitude of functional symptoms without any demonstrable underlying disease. It is estimated that up to 30 to 40% of patients attending a general practitioner’s office have some form of depression and in the fall and winter season a large percentage of them are due to SAD.

Treatment approaches to SAD

There are several natural approaches to SAD. However, before deciding to go this route, a psychiatrist should assess the patient to determine the risk for suicide. When a patient is not suicidal, light therapy can be utilized.

1. Light therapy: According to Ref. 2 a light box from Sun Box or Northern Light Technologies should be used for 30 minutes every morning during the fall and winter months. The box should emit at least 10,000 lux. Improvement can occur within 2 to 4 days of starting light therapy, but often takes up to 4 weeks to reach its full benefit (Ref.2).

2. Exercise reduces the amount of depression. The more exercise is done the less depression remains. A regular gym workout, dancing, walking, aerobics and involvement in sports are all useful.

3. Folate and vitamin B12: Up to 1/3 of depressed people have folate deficiency. Supplementation with 400 mcg to 1 mg of folic acid is recommended. Vitamin B12 should also be taken to not mask a B12 deficiency (Ref.3). Folate and vitamin B12 are methyl donors for several brain neuropeptides.

4. Vitamin D3 supplementation:A large Dutch study showed that a high percentage of depressed patients above the age of 65 were deficient for vitamin D3. Supplementation with vitamin D3 is recommended. (Ref.3). Take 3000 to 4000 IU per day, particularly during the winter time.

5. St. John’s Wort (Hypericum perforatum) has been found useful for minor to moderate depression. It is superior in terms of having fewer side effects than standard antidepressant therapy (Ref.3).

6. Standard antidepressants (bupropion, fluoxetine, sertraline and paroxetine) are the treatment of choice by psychiatrists and treating physicians when a faster onset of the antidepressant effect is needed (Ref.3).

7. Electro acupuncture has been shown in many studies to be effective in ameliorating the symptoms of depression and seems to work through the release of neurotransmitters in the brain (Ref.4).

8. A balanced nutrition (Mediterranean type diet) including multiple vitamins and supplements (particularly the vitamin B group and omega-3 fatty acids) also stabilize a person’s mood (Ref.3). Pay particular attention to hidden sugar intake, as sugar consumption is responsible for a lot of depression found in the general population.

9. Restore sleep deprivation by adding melatonin 3 to 6 mg at bedtime. This helps also to restore the circadian hormone rhythm.

Conclusion

Seasonal affective disorder is triggered by a lack of light exposure in a sensitive subpopulation. An integrative approach as described can reduce the amount of antidepressants that would have been used in the past in treating this condition. This will reduce the amount of side effects. The use of a light box can reduce the symptoms of this type of depression within a few days. But the addition of electro acupuncture and St. John’s Wort may be all that is required for treatment of many SAD cases. Regular exercise and a balanced nutrition (with no sugar) and including vitamin supplements complete this treatment. If the depression gets worse, seek the advice of a psychiatrist and make sure your doctor has ordered thyroid tests and hormone tests to rule out other causes where depression is merely a secondary symptom.